Drug & supplement interaction

Hibiscus Sabdariffa + Enasidenib

Enasidenib brand name: Idhifa.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Enasidenib falls into 7 drug categories that Hibiscus Sabdariffa can interact with; the most serious is rated minor. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C19 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
Interactions7
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hibiscus Sabdariffa and Enasidenib

These two interact in 7 distinct ways. Each one is explained separately below.

Why Are There 7 Interactions?

Hibiscus Sabdariffa interacts with whole categories of medication. Enasidenib falls into 7 of those categories, so it can interact with Hibiscus Sabdariffa in 7 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Minor).

Minor

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 7

Why this applies to Enasidenib

Enasidenib falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Hibiscus Sabdariffa interacts with.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C19 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C19. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: lab studies suggest hibiscus may slow down an enzyme in your liver called CYP2C19, which helps process certain medicines, including enasidenib (Idhifa). In theory, if that enzyme works more slowly, a bit more enasidenib could linger in your body. That might mean slightly more of its known effects, like nausea, diarrhea, or changes in your liver and blood tests.

I want to keep this in perspective, though. This is a theoretical concern seen only in test tubes, never reported in real patients, and it's rated as minor. A cup of tart hibiscus tea is unlikely to be a problem. Still, since enasidenib is a serious cancer drug, please run any concentrated hibiscus supplement past your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 7

Enasidenib also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP1A2 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP1A2. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for anyone taking enasidenib (Idhifa) alongside hibiscus. In lab studies, hibiscus extract can slow down a liver enzyme called CYP1A2, which is one pathway your body uses to clear enasidenib. In theory, blocking that enzyme could let a bit more of the drug build up, which might nudge up side effects like nausea, diarrhea, tiredness, or changes in blood counts.

That said, this is only a theoretical concern from test-tube research, and it hasn't been seen in real patients. A cup or two of hibiscus tea is unlikely to cause trouble, but concentrated supplements are a different story. Since enasidenib is a serious cancer medicine, please run any hibiscus supplement past your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

3 of 7

Enasidenib also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2D6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2D6. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with hibiscus and your leukemia medicine, Enasidenib (Idhifa). In a lab dish, hibiscus extract slowed down an enzyme called CYP2D6. Since Enasidenib is partly handled by that same enzyme, the theory is that hibiscus could let a bit more of the drug build up in your body. If that happened, you might see slightly stronger Enasidenib effects, such as nausea, diarrhea, fatigue, or changes in lab values your oncology team already watches closely.

I want to keep this in perspective: this is only a theory from test-tube work, and it has never actually been reported in people. A cup of tart hibiscus tea is unlikely to be a problem, but concentrated supplements are a bigger unknown. Please run it by your oncology pharmacist or doctor before adding hibiscus.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

4 of 7

Enasidenib also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2C9 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C9. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: hibiscus may gently block a liver enzyme called CYP2C9, and your leukemia medicine enasidenib (Idhifa) is partly handled by that same enzyme. In theory, slowing that enzyme could let a bit more enasidenib build up in your body, which might nudge up side effects like nausea, diarrhea, or changes in your blood counts and bilirubin.

I want to be straight with you, though: this is a theoretical concern based only on lab-dish studies, not real people, and it's rated as minor. An occasional cup of tart hibiscus tea is unlikely to cause trouble. Concentrated hibiscus supplements are where I'd be more cautious. Since enasidenib is a serious cancer drug, please run any hibiscus supplement past your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

5 of 7

Enasidenib also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP3A4 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP3A4. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body uses a liver enzyme called CYP3A4 to help break down enasidenib (Idhifa). In lab dish studies, hibiscus extract appears to slow that enzyme down a bit. If that happened in real life, enasidenib could clear a little more slowly and build up, which in theory might mean more of its known side effects, like nausea, low appetite, diarrhea, or elevated bilirubin showing up on bloodwork.

That said, I want to be honest about the strength here. This is theoretical and comes only from test-tube data, with nothing reported in actual patients. A cup of tart hibiscus tea is unlikely to matter. Still, since enasidenib treats a serious leukemia, please run any concentrated hibiscus supplement past your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

6 of 7

Enasidenib also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, Hibiscus sabdariffa might reduce the metabolism of CYP2C8 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2C8. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version on pairing hibiscus tea with your Idhifa (enasidenib). Lab tests in a test tube suggest hibiscus extract can slow down a liver enzyme called CYP2C8, which is one of the enzymes that helps clear enasidenib from your body. In theory, slowing that enzyme could let a bit more of the drug build up, which might mean stronger effects or a higher chance of side effects like nausea, diarrhea, low appetite, or changes in blood counts and liver labs.

That said, I want to keep this in perspective. This is only seen in lab studies, not in real people, and the interaction is rated minor. A cup of hibiscus tea is unlikely to be a problem, but with a serious cancer drug like this, please check with your oncologist or pharmacist before using concentrated hibiscus supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.
Minor

CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES

7 of 7

Enasidenib also falls under CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2B6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2B6. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: your leukemia medicine Enasidenib (Idhifa) is partly cleared by a liver enzyme called CYP2B6. In a lab dish, hibiscus extract slowed that same enzyme down a bit. In theory, that could mean a little more Enasidenib sticking around in your body, which in turn might mean slightly more of its known side effects, things like nausea, diarrhea, or changes on your blood and liver lab work.

The reassuring part: this is only a theoretical, test-tube finding and has never actually been reported in real people. It's rated minor. Occasional hibiscus tea is very unlikely to cause trouble. Still, with a cancer drug like this, I'd loop in your oncology team or pharmacist before using concentrated hibiscus supplements, just so everyone's on the same page.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Hibiscus Sabdariffa Also Interacts With Other Medications

Hibiscus Sabdariffa has 2 major, 266 moderate, 818 minor known drug interactions in our database — the Enasidenib one above is among them. If you take anything else, check it against the full list below.

Major 2 Moderate 266 Minor 818 No known interaction 1,744 (incl. Enasidenib)
Taking anything else?

Check Another of Your Medications Against Hibiscus Sabdariffa

Covers the 2,830 medications we’ve checked against Hibiscus Sabdariffa. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Enasidenib

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enasidenib page lists 203 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 156 moderate · 44 minor.

From our pharmacist’s overview on the Enasidenib page

“Anyone taking enasidenib (Idhifa) for acute myeloid leukemia should treat this supplement list with genuine care, beginning with the major-rated entries: grapefruit, St. John's wort, and activated charcoal.”

Reviewed by 2 · Jul 18, 2026

Open the Enasidenib interaction page

How much people look this up

Where Hibiscus Sabdariffa and Enasidenib Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Hibiscus Sabdariffa
Top half

#495 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Enasidenib
Steady interest

#2,285 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Hibiscus Sabdariffa

What is Hibiscus Sabdariffa?

Hibiscus Sabdariffa
  • High blood pressure
  • Heart and cholesterol health
  • Digestive upset
  • Antioxidant support
  • Fever and general wellness

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and while hibiscus tea is generally well tolerated in food amounts, concentrated supplements should be used cautiously and avoided in pregnancy. Talk to your pharmacist or doctor before using it for a medical condition.

Read the full Hibiscus Sabdariffa monograph & all interactions
Medication

About Enasidenib

What Is Enasidenib Used For?

Brand name: Idhifa

Idhifa (enasidenib) is used to treat adult patients with acute myeloid leukemia (AML) — a fast-moving cancer of the blood and bone marrow — whose disease has come back after treatment (relapsed) or has stopped responding to treatment (refractory). It is specifically for patients whose leukemia has a mutation in the IDH2 gene, which must be confirmed by an FDA-approved test before starting therapy.

See full Enasidenib drug information
Keep checking

Other Drugs & Hibiscus Sabdariffa

Browse every other medication we’ve checked against Hibiscus Sabdariffa — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
266Moderate
818Minor
1,743No known interaction
2 Major 266 Moderate 818 Minor 1,743 No interaction
Major

2 interactions

Moderate

266 interactions

Showing 60 of 266 moderate interactions — see all 266 on the Hibiscus Sabdariffa page.

Minor

818 interactions

Showing 60 of 818 minor interactions — see all 818 on the Hibiscus Sabdariffa page.

No interaction 1,743 drugs checked — show the list

We also checked Hibiscus Sabdariffa against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,743 medications checked with no known interaction — see the full Hibiscus Sabdariffa list.

See the full Hibiscus Sabdariffa interactions page
See every supplement checked against Enasidenib, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Hibiscus Sabdariffa monograph › Uses, safety, and every drug interaction in one place Enasidenib supplement interactions › Every supplement checked against Enasidenib, ranked by severity Enasidenib drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Hibiscus Sabdariffa and Enasidenib Together: Common Questions

Can you take Hibiscus Sabdariffa with Enasidenib?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 7 interactions listed for Hibiscus Sabdariffa and Enasidenib?
Enasidenib belongs to more than one drug category, and Hibiscus Sabdariffa interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Hibiscus Sabdariffa and Enasidenib interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Enasidenib and Hibiscus Sabdariffa?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.